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Background: A defining characteristic of expertise is the use of intuition to navigate tasks. The construct of intuition and its importance is well-studied in other disciplines, but little is known about how it translates to engineering. Existing literature on intuition does not clearly define the construct and its relationship to problem solving, which creates a substantial gap in our understanding of intuition and its applicability to engineering. Purpose: This study's purpose is to better understand the relationship between expertise, decision-making, and intuition from the perspective of engineering practitioners. We additionally seek to define engineering intuition from this same perspective. Design/Methods: Seventeen semi-structured interviews were conducted with engineering practitioners with at least 6 years of experience. Sensitizing concepts tied to models of expertise development and dual process cognition were used to guide the study's design and data analysis. Iterative qualitative analysis culminating in code mapping supported the development of a definition and theory of engineering intuition. Results: This study's result is an emergent definition of engineering intuition and a complementary framework called Leveraging Intuition Toward Engineering Solutions (LITES). LITES uniquely situates intuition as part of the problem-solving process among experienced engineering practitioners and describes how practitioners use their intuition. Conclusions: This work advances knowledge of the relationship between intuition and expertise in engineering education by providing a definition of engineering intuition and a framework describing intuition's role in engineering problem solving. This contribution furthers efforts to equip current and future engineers with the necessary skills to navigate existing and upcoming societal challenges.

Abstract Background Universal immunisation is the cornerstone of preventive medicine for children, The World Health Organisation (WHO) recommends diphtheria-tetanus-pertussis (DTP) vaccine administered at 6, 10 and 14 weeks of age as part of routine immunisation. However, globally, more than 17 unique DTP-containing vaccine schedules are in use. New vaccines for other diseases continue to be introduced into the infant immunisation schedule, resulting in an increasingly crowded schedule. The OptImms trial will assess whether antibody titres against pertussis and other antigens in childhood can be maintained whilst adjusting the current Expanded Programme on Immunisation (EPI) schedule to provide space for the introduction of new vaccines. Methods The OptImms studies are two randomised, five-arm, non-inferiority clinical trials in Nepal and Uganda. Infants aged 6 weeks will be randomised to one of five primary vaccination schedules based on age at first DTwP-vaccination (6 versus 8 weeks of age), number of doses in the DTwP priming series (two versus three), and spacing of priming series vaccinations (4 versus 8 weeks). Additionally, participants will be randomised to receive their DTwP booster at 9 or 12 months of age. A further sub-study will compare the co-administration of typhoid vaccine with other routine vaccines at one year of age. The primary outcome is anti-pertussis toxin IgG antibodies measured at the time of the booster dose. Secondary outcomes include antibodies against other vaccine antigens in the primary schedule and their safety. Discussion These data will provide key data to inform policy decisions on streamlining vaccination schedules in childhood. Trial registrations ISRCTN12240140 (Nepa1, 7th January 2021) and ISRCTN6036654 (Uganda, 17th February 2021).

BACKGROUND: Pancreatic pseudocysts are walled-off collections of necrotic tissue, old blood, and secretions that are encapsulated. Collections lack a real capsule, and the cyst wall is composed of nearby viscera such as the stomach and/or colon. Pseudocysts are the most frequent side effects of both acute and chronic pancreatic inflammation. In our prospective interventional study, 25 patients with symptomatic pancreatic pseudocysts were included. Majority of patients were belonged to the age group of 31–40 years, with males being more common. The most common cause is alcoholism, followed by idiopathy. Most of them presented with pain abdomen as the chief complaint. Ultrasonography (USG) and computed tomography (CT) of the abdomen were found to be accurate investigations. Acute pseudocysts were managed conservatively, whereas infected cysts necessitated external drainage. In the majority of cases, anastomoses of the cyst to the nearby bowel, either cystogastrostomy or cystojejunostomy, were performed with good results. METHODS: Study design - Hospital-based prospective interventional study. Sample size - 25. The study was the prospective interventional study, conducted at Basaweshwar Hospital from July 2020 to August 2022, 25 patients with symptomatic pancreatic pseudocysts included. Patients had baseline tests as well as specific tests such as serum amylase and serum lipase. All patients underwent USG and CT Abdomen to determine the morphology, and treatment was planned accordingly. RESULTS: A total of 25 patients were included in the study. Out of 25 patients, the cause of pancreatic pseudocyst was found to be alcohol consumption in 80% and other causes in 14%. The common indication for intervention was persistent pain (60%) The type of intervention was chosen based on the physical state of the patient as well as the location and type of the pseudocyst. USG-guided drainage was done in 14% and surgical drainage procedure-cystogastrostomy - 36% and cystojejunostomy 26%. CONCLUSION: The most common cystic lesion of the pancreas is the pancreatic pseudocyst. The disease was common in the age group of 31–50 years and was seen predominantly in males. The most common cause is alcoholism, followed by idiopathy. Pain in the abdomen with tenderness is a common presentation. The most useful tests were an ultrasound and a CT scan. Acute pseudocysts were managed conservatively, while infected cysts required external drainage. In the majority of cases, anastomosis of the cyst to the nearby bowel, either by cystogastrostomy or cystojejunostomy, was performed with good results.

Background: Road traffic accidents are as war on the roads and it takes the lives of approx 1.2 million individuals around the world. It is direct effect of modern day urban civilization. Occupied time between the accident and reaching the hospital is life-threatening and that is a very important gap to provide medical first aid to the victims. In urban life, 75% of thoracic trauma follows blunt injury. Greatest difficulty is faced in their management and long time in diagnosis. Hence, objective of study is to get knowledge of the blunt chest injuries among accident victims travelling in different modes of road transportation. Material and Methods: Data was collected from 100 cases of death by road traffic accident that were brought for medico-legal autopsy at the mortuary of Forensic Medicine Department, Rajrajeshwari Medical College and Hospital Bengaluru, during the period from December 2013 to May 2015. Results: Out of 100 cases studied, high risk of age of the victims were between 21-40 years (male 43.9% and female 44%). Males (82%) included the majority of victims as compared to females (18%) in the ratio 4.5:1. Most of the victims died on spot or within 6 hours of the incident (80%). Two-wheeler occupants (62%) were the commonest victims involved in RTA. Most of the RTA occurred in highway roads (78%). Most of patients succumbed on the way to hospital (54%). Conclusion: All blunt thoracic traumas constitute potential factor in increasing the amount of morbidity and mortality and therefore proper attention towards their accurate diagnosis and satisfactory management is mandatory. Last but not the least; a multidisciplinary approach is required for treating trauma victims.

Introduction Inactivated, viral vector and mRNA vaccines have been used in the Nepali COVID-19 vaccination programme but there is little evidence on the effectiveness of these vaccines in this setting. The aim of this study is to describe COVID-19 vaccine effectiveness in Nepal and provide information on infections with SARS-CoV-2 variants.Methods and analysis This is a hospital-based, prospective test-negative case–control study conducted at Patan Hospital, Kathmandu. All patients >18 years of age presenting to Patan Hospital with COVID-19-like symptoms who have received a COVID-19 antigen/PCR test are eligible for inclusion. The primary outcome is vaccine effectiveness of licensed COVID-19 vaccines against laboratory-confirmed COVID-19 disease.After enrolment, information will be collected on vaccine status, date of vaccination, type of vaccine, demographics and other medical comorbidities. The primary outcome of interest is laboratory-confirmed SARS-CoV-2 infection. Cases (positive for SARS-CoV-2) and controls (negative for SARS-CoV-2) will be enrolled in a 1:4 ratio. Vaccine effectiveness against COVID-19 disease will be analysed by comparing vaccination status with SARS-CoV-2 test results.Positive SARS-CoV-2 samples will be sequenced to identify circulating variants and estimate vaccine effectiveness against common variants.Measuring vaccine effectiveness and identifying SARS-CoV-2 variants in Nepal will help to inform public health efforts. Describing disease severity in relation to specific SARS-CoV-2 variants and vaccine status will also inform future prevention and care efforts.Ethics and dissemination Ethical approval was obtained from the University of Oxford Tropical Ethics Committee (OxTREC) (ref: 561-21) and the Patan Academy of Health Sciences Institutional Review Board (ref: drs2111121578). The protocol and supporting study documents were approved for use by the Nepal Health Research Council (NHRC 550-2021). Results will be disseminated in peer-reviewed journals and to the public health authorities in Nepal.

Context: Gender-based discrimination is more predominant in India. In spite of various laws, gender inequality is an evil that plagues society even today. This is an important challenge for meeting our Sustainable Development Goals. Methods: This cross-sectional study was carried out in an urban field practice area. Study subjects were married women and their husbands in the age-group of 15–49 years along with their under-five children. Gender egalitarianism was assessed for factors like education, employment and media exposure. Factors which were studied for revealing gender egalitarianism among children included sex ratio, immunization status, nutritional status and health care expenditure. Completed family size and preference for the sex of the child were enquired about to assess the inclination towards male gender of the baby. Anthro software was used for statistical analysis. Results: Gender egalitarianism was found with regards to education. However, significant difference was noted in the employment status of men and women. Overall, sex ratio was in favor of girls. Though gender inequality was evident from the results, it was more in favor of girls. There was no evidence of gender bias for immunization of children. It was observed that more boys were stunted than girls and almost equal proportion of boys and girls were wasted. Conclusions: Factors like high literacy, control over income, access to financial resources made women more empowered and such empowered women were less likely to show son preference. Hence, there was no gender inequality among children in the present study.

The present investigation centres on the application of quantum chemistry to clarify the innovative synthetic pathway for Gefitinib derived from methyl 2-isocyano-4,5-dimethoxybenzoate. This pathway encompasses various chemical reactions such as cyclization, halogenation, regioselective demethylation, Williamson's ether synthesis, and nucleophilic aromatic substitution. The reaction necessitates the presence of four intermediate species and yields a total of 11 transition states [TS]. The energies of each reactant, intermediate, and product were determined through the utilisation of density functional theory (DFT) with B3LYP/6-311+G(d) serving as the basis set. The energy diagram that was obtained shows that the new plan that was suggested could follow an easy path to obtaining the product. [ABSTRACT FROM AUTHOR]

Introduction- Injuries are increasingly recognized as a global public health epidemic. Around the world, almost 16,000 people die every-day from all types of injuries. Injuries represent 12% of the global burden of disease, the third most important cause of overall mortality and the main cause of death among 1-40-year age groups. Methodology- This hospital based cross-sectional study was conducted among the road traffic accident patients admitted in trauma care center of Government Medical College and Hospital Nagpur. Result- Most common type of injury was abrasion in 91.45% followed by laceration in 79.61% of study subjects. Other common injuries were contusion, fracture, internal hemorrhage, crush injury and dislocation. Majority of the study subjects i.e. 67.11% had head injury. Conclusion- Head injury was the most common injury found in the study. Abrasion and laceration was also more commonly found in study subjects. Head injury was found more in non-users of personal protective devices which was statistically significant.

Financial well-being (FWB) is critical to subjective well-being—a crucial component in measuring social progress. This study explores the simultaneous influence of five psychological traits of financial self-efficacy, risk tolerance, a propensity to plan, materialism and the tendency for social comparison on FWB. The study is a cross-sectional causal investigation using a web-based survey. The survey was administered to individuals who were active in financial decision-making activities and selected using a combination of judgmental and snowball sampling. Structural equation modelling revealed a positive influence on financial self-efficacy and propensity to plan and the negative impact of risk-tolerance, materialism and a tendency for social comparison on subjective FWB. Financial institutions and educators may utilize the study results for improving characteristics that help their clients make better financial decisions and enjoy higher levels of financial and subjective well-being. The study makes two contributions to the existing literature on the subject. First, the study simultaneously investigates the effect of the five psychological traits on subjective FWB—not attempted hitherto. Additionally, the study provides an Indian perspective on the subject, an emerging country covering one-sixth of the world population. [ABSTRACT FROM AUTHOR]